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General NPI Number Information
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NPI Number | 1306475306
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Entity Type | Organization
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Legal Business Name | ADVANCED TELEMEDICINE LLC
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Dates
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Enumeration Date | 04/02/2020
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Last Update Date | 07/31/2020
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Provider Practice Location Address
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Address Line | 6 W RIVER ST UNIT 491
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City | MILFORD
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State | CT
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Zip | 06460-9471
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Country | US
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Telephone | 800-835-9812
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Fax | 888-978-3688
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Provider Business Mailing Address
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Address Line | 17 MAYFLOWER CT
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City | MILFORD
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State | CT
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Zip | 06460-4518
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Country | US
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Telephone | 800-835-9812
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL/PROVIDER
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Name | MICHELE L VALLEE
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Credential | NP
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Telephone | 860-483-1074
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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